Health Topics Information

Rhabdomyolysis and Extreme Exercise

In today's busy world, you may find yourself cramming in a few intense work-out sessions here and there around your hectic schedule.  You might have joined a fitness class or started a video work-out program designed to push your body to its limits, all in the name of burning the most calories in the shortest amount of time possible.  If this sounds like you, there’s a rare but serious condition you should be aware of: Rhabdomyolysis, or “Rhabdo” for short.


This is a very specific medical term which, when used in the context of excess or increased exercise, is the breakdown of muscle from extreme physical exertion. This can be a life-threatening condition.  In the case of rhabdomyolysis, excessive exercise can lead to extreme muscle breakdown or muscle death, which in turn causes muscle enzymes or proteins from this dying muscle tissue to leak into the blood stream. This protein then needs to be filtered out by the kidney. Oftentimes if treatment is not sought for this condition, there will be too much protein for one’s kidney to handle or filter, leading to clogging of this protein in the kidney.  Think of it as a clogged pipe, and when the pipe or kidney filter is plugged, it fails or kidney failure ensues. This can lead to rapid or severe illness, permanent kidney damage and even death.

While rare, rhabdo is being seen and diagnosed more commonly in emergency departments and hospitals, often due to fitness crazes and the desire to push oneself beyond reasonable physical limits.

With that being said, how can one prevent this scary condition? Studies show this can happen in 2-40% of extreme exercisers. First and foremost, recommendations are to stay adequately hydrated, most importantly throughout your day, not just during your exercise routine. Next, ease into your New Year’s exercise goals. “Weekend warriors” are at most risk for rhabdo. If you are a rookie exerciser, start with 10-20 minutes sessions and work your way up slowly, three to five days per week. 

Signs and symptoms of rhabdomyolysis are:

  • Progressive, extreme muscle pain after or during exercise
  • Muscle swelling or enlargement
  • Muscle weakness
  • Bruising noted to the skin over affected muscles
  • Excessive fatigue
  • Low urine output
  • Tea-colored urine or blood noted in the urine
  • Fever
  • Nausea / vomiting

This condition is diagnosed by physical exam by your provider along with blood and urine testing.

If you suspect this may be happening, it is recommended to seek medical treatment as soon as possible.  Again, it is a fairly rare condition, but definitely something to keep in the back of your mind when starting in on those resolutions – life is like a marathon, not a sprint. Slow and steady wins the race and is usually the most sustainable goal! Good luck and be safe!

Amie Schillinger, PA-C, is a Physician Assistant currently providing hospitalist coverage at CHI St. Alexius Health Dickinson Medical Center. Amie lives in Dickinson with her husband and three children.